olice officers enter the lives of those they serve in critical moments. When a crime or other emergency occurs, police officers are often the first responders in moments that will shape the futures of all those involved. These situations can be dangerous, highly stressful, and even traumatic for officers and the public. Beyond protecting physical safety, police leaders should be aware of the impact these encounters have on the mental health of individuals in their communities and the law enforcement officers serving those communities. Police departments can work with providers and communities to build systems that improve response to people with mental and substance use disorders while providing supports for the police and reducing the potential for further crime and trauma.

The Substance Abuse and Mental Health Services Administration (SAMHSA) has made criminal justice issues the focus of one of eight strategic initiatives guiding the agency’s work through 2014. In 2007, SAMHSA collaborated with the IACP to hold a youth dialogue, sponsored by the U.S. Capitol Police Department. In 2009, SAMHSA partnered again with the IACP on the national policy summit report, Building Safer Communities, Improving Police Response to Persons with Mental Illness. The summit discussed how individuals with behavioral health problems are more likely to be crime victims than other members of the public and may come into contact with law enforcement as a result of disturbances related to their illnesses. People with mental health and substance use disorders are overrepresented in correctional settings. Traditional law enforcement responses to these individuals can be counterproductive for the public, law enforcement, and corrections. Traditional responses often also fail to improve management of behavioral health problems, resulting in repeated incidents and arrests, further taxing already strained systems. Fortunately, strategies and programs from diversion to reentry exist that promote public safety and improve outcomes for people with mental and substance use disorders. SAMHSA wants to work more closely with the IACP to influence positive change and system reform to protect both the safety of officers and the people they encounter with behavioral health concerns.

The IACP has been a consistent leader on these issues. Since the IACP made police response to persons with mental illness the focus of its national policy summit, we at SAMHSA are continuing our dialogue and working together on developing a youth dialogue to further explore possible diversion and other responses to youth to address the issue of disproportionate minority contact that results in too many minority youths becoming involved with the juvenile and criminal justice systems. Public health and public safety need to work together toward solutions that respond effectively and compassionately to children, youth, and adults with substance abuse and behavioral health challenges. We can positively impact the violence and trauma our children and youth encounter.

SAMHSA is encouraging police departments and behavioral health providers to work together to divert individuals with mental health, substance abuse conditions, or both before formal arrest is necessary. To do so, police need to feel comfortable calling on community providers when available to respond quickly to assist persons in need before police may need to arrest an individual. Likewise, community providers need to feel assured that police will help their workers be safe during crisis intervention on the street, in homes, or in businesses.

Research tells us that the majority of behavioral health issues in adults begin in childhood or adolescence. The IACP policy summit report also noted the importance of addressing the unique developmental needs of children and youth with behavioral health problems. It is equally important for police responding to incidents involving children or youth with behavioral health problems to attempt to de-escalate situations and connect these young people with resources to help them manage their illnesses. Children and youth in families and neighborhoods impacted by crime are more likely to witness and be affected by crime and trauma, even in law enforcement responses. Exposures to traumatic incidents and family disruption have been linked to future health problems, including substance abuse and mental illness. This means that first responders have the added responsibility to try to minimize the potential negative impact that may result when they must intervene.

It also is important and in the best interest of police to help youth with behavioral health needs and substance abuse as early as possible. The IACP’s several youth-focused policing initiatives speak to the association’s commitment to this concern. The best path to long-term abstinence from substances is community-based treatment and support services for youth. As a result, connecting youth who have substance use problems with community-based treatments and supports as early as possible serves police departments’ broader missions to prevent crime and improve public safety. The alternative—juvenile justice or adult correctional placement—too often leads to the expensive and destructive cycle of repeat offense and recidivism.

None of this, of course, is simple. The impact of continued violence and trauma on law enforcement officers is being addressed at the IACP through the Center for Officer Safety and Wellness. SAMHSA acknowledges this valuable step to impact the far too high rate of police suicide. We encourage continued focus on change in police culture to reduce the misunderstanding and prejudice for officers seeking help or behavioral health services. Police departments should consider sharing resources for those in crisis—for example, SAMHSA’s National Suicide Prevention Lifeline, available at 1-800-273-TALK.

Though their first job is public safety, police are a critical component of our nation’s behavioral health system. Law enforcement has an important role to play to connect individuals with services and supports that will reduce problematic behavior and promote public safety. Likewise, community providers are a key part of a police officer’s resources in responding to behavioral health and public safety issues. These providers must be available to collaborate with police departments and individual police officers, not only in their work with the public but also in addressing the needs of police officers and their families.

By working to implement effective models of system coordination, diversion, and reentry, police can help individuals with mental and substance use disorders address their illnesses and promote healthier communities. At the same time, communities have a responsibility to police officers to recognize their important and difficult jobs and to provide them with support on the job and in their personal lives.

SAMHSA looks forward to further collaboration with the IACP to advance our shared goals of public health and public safety. ♦

From The Police Chief, vol. LXXX, no. 1, January 2013. Copyright held by the International Association of Chiefs of Police, 515 North Washington Street, Alexandria, VA 22314 USA.

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